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Tuesday 30 September 2014

Addressing the "I.P.", The I.P. Address or Dealing with The Identified Patient

by Stephen B.Chadwick, MA Counselling Psychology.

In common computer lingo, an "I.P." or "I.P." address is a term used to describe your "internet protocol" address, so I am told. For anybody with a computer it identifies and pinpoints where you personally  are within the world and on the web or internet.  This quirky series of numbers basically identifies you and your location geographically on the globe.
Moreover, information that you send out or receive can be identified or traced back to that spot or that computer from where or to where the information was transmitted.
"I.P.'s" for counsellors or psychotherapist though have a totally different meaning but curiously, a metaphor for one can be seen for the other. I.P.'s  are the "identified patient". Now, you're probably asking yourself: "What does that mean?" or even "Wow, that sounds a bit clinical and maybe even a bit scary!"  -- Don't worry. It's not.

In every area of specialization, from computers to psychotherapy, there are always these terms or expression which can be terribly  confusing  until someone explains it, such as "internet protocol" address or  IP. So, we know an IP can also be the "identified patient" -- but what exactly does that mean?

 The identified patient is the so-called "one with the problem".

So, remember how I said that an "I.P." (internet protocol) could be like an analogy for an IP (identified patient)? Well, the I.P. address with a computer is kind of like an address on a house. It's where you're at. I.P (computer) addresses sit in a "web" or "network" or "family" of addresses in a geographic area.

So too (in some way) with IP (identified patient) within a family. The human IP is usually the poor, unfortunate individual within a network or family whom everyone identifies as the patient and who usually gets dragged (sometimes kicking and screaming) into counselling or therapy. Or, alternatively, the IP, or identified patient is the one within the family who, recognising that they have some dysfunction, voluntarily goes into therapy to resolve their distress. In the most basic terms, the identified patient is the so-called "one with the problem" or the one whom, everyone else within the family sees as either having all the problems or being the problem. Sometimes these people are called "the black sheep of the family."

However, it is not so simple as that.

John Bradshaw
A number of years ago, a man by the name of John Bradshaw did a very interesting documentary TV seminar series on PBS (Public Broadcasting System) entitled "Homecoming."

It was very popular, but what was fascinating was the approach he used. His approach, which was not new, was the "Systems" or "Family Systems" view. Now here we could go back and make another reference to systems and "computer systems" since we had been talking about I.P. addresses and internet protocols, and such. And there is again also a parallel or analogy with "computer systems" and "family systems".

Families, too, are an independent web or network 

Effectively, families just like a computer network, are interlinked. So, within any family, each family member will play a unique role or part within the functional (or dysfunctional) system. So just like a computer has various parts within it: screen, hard drive, motherboard, etc. in order to be able to function, families too, are an interdependent web or network. One could even think of families almost like eco systems. So the concept of a family as as "system" was beautifully illustrated by Bradshaw by the use of a  mobile. And no, when I speak of "mobile" I'm not thinking about the electronic age. So no, I am not thinking about this:

I am talking about one of these: 

Hanging mobile of people


Basically, what you do to one small part (of the mobile) will have a movement effect on the rest of the mobile. If all the parts are interdependent, if you hit one part of the system, you are going to affect the other parts. Visually if you look at it as a matrix or a puzzle or a stone archway, if you remove or change one part, the matrix or puzzle or structure may shift or collapse in on itself. Here a visual might help.

So, clearly if you remove the keystone, then the entire structure collapses. It's just that for any family, EVERY member of the family is a keystone as they all play a role within the family structure.

When one system member goes, the family struggles to find a new balance.

We probably need here a  more concrete example (forgive the pun) , so let's look at this clip of the film Ordinary People (1980)with Mary Tyler Moore, Timothy Hutton and Donald Sutherland. Ordinary People tells the story of a family coping with the drowning death of their older son, who is survived by his younger brother Conrad( Hutton), the mother Beth (Tyler Moore) and the father Calvin (Sutherland). Conrad is also struggling with a suicide attempt brought on by his survivor guilt due to his surviving and not his older, idolized brother Buck.   

Family dysfunction tends to get focussed or funnelled in or onto one member of the family 

Effectively when one system member (of the family) goes,  the whole family struggles to find a new balance, and a new equilibrium in the process. Clearly, Timothy Hutton is the "identified patient", although, also clearly, the mother, the father and the entire family is the "identified patient", however it is only Conrad (Hutton) who is seeing a psychiatrist. It is upon him whom all the emotions hang.

And most recently another film called Rachel Getting Married (2008) with Anne Hathaway in the role of  Kym as the I.P. shows again how overall family dysfunction tends to get focussed or funnelled into one member of the family. Kym(Hathaway) is the sister of Rachel, who is due to be married. However Kym has only just been released from rehab a few days earlier in order to attend her sister Rachel's wedding. The timing of the wedding close to the release from hospital of a fragile family member is in itself enough to shout "dysfuntion", but the denial, blame-shifting and hostile family dynamics become evermore clear in the emotional tension in the buildup to the wedding. Again, here the family's dysfunction is centered in one person, rather than being divided up equally so that everyone gets a piece of the pie.

I'll stop here for now, but from what I've already talked about, it can be very easy indeed to start taking some or even all of the blame off of the IP and instead spread it around manure-like in the family "garden". This manifests more commonly as what is known in common parlance as a sh*t-fight!

I'll speak a little bit more about this and family dynamics  and the IP in my next post entitled: The Blame Game.

Take Care,


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